Cerebellar Function

Cerebellar function is tested by the following:

# Finger-to-nose test Heel-to-knee test

• Rapid alternating movement Romberg test

Gait assessment

Perform the Finger-to-Nose Test

The finger-to-nose test is performed by asking the patient to touch his or her own nose and the examiner's finger alternately as quickly, accurately, and smoothly as possible. The examiner holds a finger at arm's length from the patient. The patient is instructed to touch the finger and then the nose. This is repeated several times, after which the patient is asked to perform the test with eyes closed. This is demonstrated in Figure 21-56. Patients with cerebellar disease persistently overshoot the target, a condition known as past pointing. They may also have a tremor as the finger approaches the target.

Perform the Heel-to-Knee Test

The heel-to-knee test is performed by having the patient lie on his or her back. The patient is instructed to slide the heel of one lower extremity down the shin of the other, starting at

Figure 21-57 Heel-to-knee test.

Figure 21-57 Heel-to-knee test.

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